A Preliminary Study Comparing Brain Cortex Activation and Functional Connectivity in Elderly Upper Limb Rehabilitation: Physical vs. Virtual Interaction Devices

This study explores brain cortex activation and functional connectivity differences in elderly upper limb rehabilitation between physical and virtual interaction devices. Methods: Twenty-two elderly participants completed button-pressing training (physical vs. virtual buttons) guided by training board lights. Near-infrared spectroscopy (NIRS) measured oxygenated hemoglobin changes in cortical regions across two training rounds. Results: Both groups showed cortical activation, with the physical group having a larger activation area, significantly stronger functional connectivity (p < .05), and activation in motor, cognitive, visual, and auditory areas—whereas the virtual group only had significant motor activation. Positive correlations were found between cognitive-motor (p < .001), auditory-motor (p < .05), and visual-motor (p < .05) activation levels. Conclusions: Physical interaction enhances elderly cortical activation area and functional connectivity vs. virtual interaction, providing a theoretical basis for device development and NIRS-based cortical activation evaluation.